Abstract: :
Purpose: To assess and optimize the follow–up of pre–termchildren, who had screening for Retinopathy of Prematurity (ROP)in a District General Hospital.Methods: A retrospective review of all babies born between 1996 and 1999fulfilling the national ROP screening criteria, was undertaken.The same cohort was traced at preschool and at 5 years of age.The criteria to pass the preschool orthoptist community assessmentwere uniocular vision of 6/9 or better (with Single SheridanGardner), no manifest deviation or significant phoria, fullocular motility, evidence of stereoacuity (tested with frisbyor lang stereotest) and the ability to overcome a 20 prism dioptrelens. To pass the 5 year school check, the children had to attaina vision of 6/6 or better on Snellen chart. Cases without bothdetails of the preschool and 5 year review were excluded fromthis study. A detailed analysis of the medical notes of thosefulfilling the criteria of this study was performed.Results: Ninety two children satisfied the inclusion criteria. Of these53.26% (49/92) had passed both their preschool and 5 year assessments.All patients had no to mild regressed ROP. Of those 32.61% (30/92),whofailed both the preschool and 5 year review, 3 had thresholdROP; 1 had unilateral total detachment and 26 had no or regressedROP. Sixteen children had strabismus (11 esotropias and 5 exotropias),2 of whom required squint surgery; 8 had significant refractiveerrors and 2 patients had a significant phoria. 14.13% (13/92)patient failed the preschool screening criteria but passed at5 years. Two had strabismus (1 had surgery), 2 had refractiveerrors and 2 had a combination of both. None had passed at preschooland failed at 5years. 6.12% (3/49) of those who passed bothassessments, 40% (12/30) of those who failed and 30.77% (4/13)of those who only passed the 5 year school check had neurologicaland other systemic disabilities.Conclusions: This study highlights the need for follow–up of thesepre–term babies within the community at an early age,due to the increased ophthalmic morbidity in premature babies,even in absence of advanced ROP. Earlier detection of ophthalmicproblems, particularly if they are amenable to treatment, mayprevent delay in management, with less disruption on the children’seducational, psychological and social behaviour.